Evidence map›Paper›PMID 31410544›Full record

ArticleJournal of bone and mineral metabolism2020

Drug holiday clinical relevance verification for antiresorptive agents in medication-related osteonecrosis cases of the jaw.

Saki Hayashida, Souichi Yanamoto, Shigeyuki Fujita, Takumi Hasegawa, Takahide Komori, Yuka Kojima, Hironori Miyamoto, Yasuyuki Shibuya, Nobuhiro Ueda, Tadaaki Kirita and 5 more

Abstract read
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In one paragraph

Article in Journal of bone and mineral metabolism, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
29citing papers in PubMed, 1 pooled it
2.8field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

29 citing papers in PubMed, 1 synthesis or guideline pooled it, 53 citations in OpenAlex.

  1. Prognostic indicators in medication-related osteonecrosis of the jaw: A systematic review and meta-analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025
    Pooled it
  2. Article
  3. Review
  4. Efficacy and risks of drug holiday in the management of medication-related osteonecrosis of the jaw in cancer patients: a single-center retrospective study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
    Article
  5. Review
  6. Article
  7. Article
  8. Article
  9. Application of bone perforation in the surgery of medication-related osteonecrosis of the jaw in stage Ⅱ.Hua xi kou qiang yi xue za zhi = Huaxi kouqiang yixue zazhi = West China journal of stomatology · 2024
    Article
  10. Long-term consequences of osteoporosis therapy with bisphosphonates.Archives of endocrinology and metabolism · 2023
    Review
  11. Article
  12. Article
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  19. Periosteal reaction of medication-related osteonecrosis of the jaw (MRONJ): clinical significance and changes during conservative therapy.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2021
    Article
  20. Denosumab-related osteonecrosis of the jaw after tooth extraction and the effects of a short drug holiday in cancer patients: a multicenter retrospective study.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2021
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 9 institutions in 1 country.

Saki HayashidaDepartment of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1, Sakamoto, Nagasaki, 852-8588, Japan. sakihaya@nagasaki-u.ac.jp.
Souichi YanamotoDepartment of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1, Sakamoto, Nagasaki, 852-8588, Japan.
Shigeyuki FujitaDepartment of Oral and Maxillofacial Surgery, Wakayama Medical University, Wakayama, Japan.
Takumi HasegawaDepartment of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
Takahide KomoriDepartment of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
Yuka KojimaDepartment of Dentistry and Oral Surgery, Kansai Medical University, Osaka, Japan.
Hironori MiyamotoDepartment of Oral and Maxillofacial Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
Yasuyuki ShibuyaDepartment of Oral and Maxillofacial Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
Nobuhiro UedaDepartment of Oral and Maxillofacial Surgery, Nara Medical University, Kashihara, Japan.
Tadaaki KiritaDepartment of Oral and Maxillofacial Surgery, Nara Medical University, Kashihara, Japan.
Hirokazu NakaharaDepartment of Dentistry and Oral Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
Mitsuyo ShinoharaFaculty of Medicine, Department of Oral and Maxillofacial Surgery, Juntendo University, Tokyo, Japan.
Eiji KondoDepartment of Dentistry and Oral Surgery, Shinshu University, Matsumoto, Japan.
Hiroshi KuritaDepartment of Dentistry and Oral Surgery, Shinshu University, Matsumoto, Japan.
Masahiro UmedaDepartment of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1, Sakamoto, Nagasaki, 852-8588, Japan.
Nagasaki University · JPKobe University · JPNagoya City University · JPNara Medical University · JPShinshu University · JPJuntendo University · JPKansai Medical University · JPOsaka City University · JPWakayama Medical University · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Treatment strategies of medication-related osteonecrosis of the jaw (MRONJ) are controversial. Recently, surgical treatment has been reported as superior to nonsurgical treatment, but the contribution discontinued antiresorptive agent use during MRONJ treatment remains unclear. This study aimed to evaluate the efficacy of drug holidays and treatment strategies in MRONJ cases. Four-hundred and twenty-seven patients with MRONJ treated at nine hospitals from 2009 to 2017 were included in this multicenter retrospective study. Multivariate Cox regression analysis showed that the primary disease (osteoporosis or malignant tumor), diabetes, serum albumin, and treatment method (surgical or nonsurgical) were significantly correlated with the cure rate. The cumulative 1-year cure rates in the surgical and nonsurgical treatment groups were 64.7% and 18.2%, respectively. However, discontinuing antiresorptive agents did not influence the treatment outcome in the cohort overall, or in 230 patients after performing propensity score matching among the discontinuation and continuation groups. When stratifying by treatment method, antiresorptive agent discontinuation significantly increased the cure rate in patients with osteoporosis who underwent nonsurgical treatment. In patients with malignant tumors undergoing nonsurgical therapy, discontinuing the antiresorptive agent was associated with a better treatment outcome, but not with statistical significance. In contrast, drug holidays showed no effect on improving outcomes in patients with both osteoporosis and malignant tumors who underwent surgical therapy. Thus, regardless of the primary disease, discontinuing antiresorptive agents during treatment for MRONJ may not be necessary and may be helpful in some cases. Future prospective trials should examine this question further.

Indexed as

AgedBisphosphonate-Associated Osteonecrosis of the JawBone Density Conservation AgentsCohort StudiesFemaleHumansLongitudinal StudiesMaleMultivariate AnalysisPropensity ScoreRetrospective StudiesTreatment OutcomeBone Density Conservation AgentsDiscontinuing medicationMedication-related osteonecrosis of the jawsPropensity scoreTreatment outcome

Identifiers

PMID31410544
OpenAlexW2968561366

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.